What has been your typical experience with a Psychiatrist for an ADHD follow-up visit

I used to visit an NP (a different provider than my PCP) for ADHD medications. After some time, she moved on. I used to visit the NP about twice a year. When I went to a visit previously scheduled with her, another doctor filled in for the vacated spot. After meeting with him, I was scheduled to visit with him about six months later.

During the second visit, he identified himself as a psychiatrist. He only asked two questions regarding the medication. The remaining time was filled with what I'll call "customer service filler". Questions regarding my occupation and the name of my employer, how long I have lived in town, etc… I replied as I would anyone else (dentist, optometrist). I assume since they charge by the minute, these were probably stock questions to fill time. The appointments are scheduled for 15 minutes.

Of course since I wasn’t prepared to meet with a psychiatrist, I was taken back by the style of the visit. I found it odd for him to wonder off topic so often. A question that really threw me was, "tell me about yourself". I'm thinking what? What are you looking for? I never had a doctor ask me that before. Anyway I figured it out. It was "to get to know me" – aka time filer. Everything is already in my file (relationship status, family medical history, test results, employer, etc…) it is all under one clinic roof, but they seem to do their best to separate mental health from the rest of the clinic.

Clearly I am not used to these type of visits. I understand most individuals have some kind of lengthy pre-appointment/evaluation/intake meeting with a psychiatrist/nurse. I was surprised with the switch and being assigned a psychiatrist. Since I was already "in the system" this type of appointment was skipped.

I am interested in what a typical experience you have with a psychiatrist for an ADHD follow-up appointment if you care to share. Exclude the initial meeting (since it’s a onetime thing) and other afflictions/reasons to visit other than ADHD (omitting things like mood, anxiety, etc…). Do you stay on topic of the medication, are your appointments "quick" or "long", or anything else you can offer.

Someone shared with me that some people during a visit will bring up random topics not related to anything. I asked about what kind of topics and they replied "anything". I told them I don't get it, I don’t know why someone would pay to talk about nothing relevant. During a physical, I got charged an extra fee because I mentioned I had an amnesiac memory experience during a work trip once. All I did was answer his question if I had anything bothering me. Since it wasn’t considered part of the preventive adult maintenance, it wasn’t covered. No co-pay – $200 out of pocket.

My next appointment is in the beginning of May and my last appointment was at the end of January with this current provider. I know everyone is different and I appreciate all the information shared. I can honestly say I have benefited from the information shared and discussed. What may seem obvious to some people, is certainly not obvious to others.

aeon

03-08-18 04:26 PM

Re: What has been your typical experience with a Psychiatrist for an ADHD follow-up v

I’ve never seen a psychiatrist for my ADHD treatment because my GP/PCP has a specialty in ADHD, and any and all treatment has been through him.

Cheers,
Ian

Kaia.S

03-08-18 05:47 PM

Re: What has been your typical experience with a Psychiatrist for an ADHD follow-up v

I'm very happy with my new psychiatrist. I found him myself after being disappointed in a adhd centre, where they spend hours asking questions from behind their screen, barely looking at me and drawing conclusions from computer results and bias from some information i gave them. The man i'm seeing now, doesn't even have a computer on his desk, and really has a conversation with me. Very to the point also, i don't know how he does it but he asks the right questions and gets more information from me within 30 minutes than the hours of questionnaires i had before. He is very openminded and treads me like a normal person, and that differs a lot from the adhd centre. Today i had my first follow up visit with him, it was about the medication, but he also asked me about what's going on and some things i told him on the first visit, and encouraged me in executing some of my plans. It took about 30 minutes and it didn't feel like he was clocking it. In the end he patiently took my blood pressure when i asked him to and wrote a new prescription. I think that a doctor with a private practise is more personal, less protocol and system limitations?

Maybe i don't understand your point, but what comes in mind is: have you been open for the person who wants to get to know you? How can you be sure it's a time filler? Also i don't understand that if someone tells you he talks about anything with his psychiatrist, that it's not relevant? It can be a two way street, you get what you put into it, as sadly not every psych is equally skilled in making things relevant. In my experience so far, some work more from theories they've learned, and some more on 'the human level', in the now. The latter is far more attractive to me. If you're not happy with your psychiatrist, i'd recommend you to find some one with a private practise; in my country that's covered by insurance as well, but i didn't know it was possible because via the GP i was send to a centre at first.

Budkeiser

03-08-18 07:59 PM

Re: What has been your typical experience with a Psychiatrist for an ADHD follow-up v

I have no problem being open and honest with a provider. Regardless if it’s the PCP, Dentist, Optometrist, or whomever. I would rather be honest and make an error, than to try to lie and conceal a problem (Do I floss? – asked the Dentist).

I am not used to meeting with a psychiatrist. The question is about context. Depending on who is asking, cues why they are asking. Then one can answer appropriately. A potential employer would receive a different reply than a neighbor just moving in next door from the exact same question, "tell me about yourself". I didn’t understand at first because I didn’t understand the context. Anything this provider required to know was already in the file compiled from the PCP, NP, Neuropsychologist, medical history, family history, medical tests, etc… Since appointments are charged per minute, up to 15 minutes, I interpreted it as, it is in their interest to maximize the full 15 minutes. He wasn't asking for new information that wasn't already available in front of him.

The person who mentioned the "anything" comment conveyed to me this was in addition to the appointment. Not directed at the reason for the visit. Therefore after I was charged an additional fee for something I thought was part of an appointment, I didn’t understand why someone would pay for something they know is not part of the appointment. If one spent 5 minutes chatting about how they need to the change dog food brand because of a coupon, it can cost an easy $60! – If I hire a plumber to fix my sink, I wouldn't pay him extra just to chat about the weather. This is different than chatting for a purpose. The service offered from a psychiatrist at my clinic is prescribing medication. Maybe they get chatty with some people, I don't know. Providers to chat with are separate providers at my clinic.

With all that said, perhaps I may have a different view next time. I will better understand the context. I wasn’t prepared to meet with a psychiatrist. I was used to a different style of appointment. I am glad you found a good partnership. I am keeping my options open.

ToneTone

03-08-18 09:05 PM

Re: What has been your typical experience with a Psychiatrist for an ADHD follow-up v

Medication management sessions are typically short.

Fifteen minutes to 30 minutes depending on the practitioner.

She asks how I've been.

I update her ... trying to remember what problems I've had and successes I have ... whether I am feeling like I need more help from my medications or whether I'm OK.

She knows I'm at work on a major creative project. She asks me about that and how that is going ...

We then get to what I'm taking and specifically whether to stay on same dose or make adjustments ...

It takes a lot of time just for the provider to to confirm what I'm taking, write out new scripts (she writes monthly post-dated scripts as "refills" aren't allowed in my state) ...

The general rule ... Unless you are paying out of network for an expensive psychiatrist, medication management sessions (that's the term for psychiatrist visits that don't involve "talk" therapy) will last 10 to 15 minutes. These meetings are incredibly short. I go to a psychiatric nurse practitioner who gives me a bit more time ... and the private out-of-insurance guy I used to go to would give me more time.

As far bringing up "anything," ... yes .... I might have met a woman I'm dating ... or broken up with a woman ... or hit a snag at my job ... When my parents died, I would share that ... Sleep problems ... stresses ... work issues ... whatever you want to share ... The more the better ... because basically there is no "irrelevant" information ...

Doesn't mean they will react to everything ... But sometimes stuff is relevant ... When my mom was ill and dying, my psychiatrist didn't want to lower my medication, something we had talked about ... he knew I would be stressed.

Sometimes we discuss my caffeine intake ... (affects sleep) ... all kinds of information can come up ...I might notice I haven't been sleeping as well and notice that I slept well when I didn't drink coffee in the afternoon ... Our bodies keep changing, so we have to keep adjusting ...

Just show up. Nothing to freak out about ... Nothing to hide ... That's the cool thing, you really don't wanna hide anything from these folks is the way I see it. They're they're to help ... and it takes a while to learn that pretty much everything in your life affects your concentration and mood ... so that's why so many topics can come up.

Tone

Budkeiser

03-08-18 09:20 PM

Re: What has been your typical experience with a Psychiatrist for an ADHD follow-up v

Excellent description Tone. Thanks! Definitely different type of appointment than I’m used to and you detailed it nicely.

sarahsweets

03-09-18 05:20 AM

Re: What has been your typical experience with a Psychiatrist for an ADHD follow-up v

Hope you dont mind but I copied and pastes this from my response in your other thread:

Quote:

Assuming this psyche doctor of yours is not a total jerk in general evals are usually an hour or so long. They involve a thorough history of childhood and beyond as far as how long you have had issues with examples to back them up. (its a good idea to write this down beforehand). The doctor will want to know what your impairments are now and what you do to mitigate them. Records from the doc you were getting meds from will be super helpful as well as anything you may have floating around from school (not a must just helpful). There are no tests for adhd. You can google "conner's scale for adhd" which is something they sometimes use for screening purposes for you and loved ones that live with you.
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